Irregular heart rhythm for 18 year old

[annako]

My son who is 18 years old sometimes experiences an irregular heart rhythm but he doe not feel it.  Its most noticable when at rest than any other time.  I took him for a check up to his doctor when he was 17 and she listened to his heart with the stethoscope and she said it sounded fine.  No irregularities and no different heart sounds.  She said the rate was normal and even spaced and not to worry.  She felt they were probably  just pac's or pvc's and stated that they are very common in teenagers and young men.  She doesnt want to alarm him and have him "worry" about them by having him go through all the tests, since she states that he is totally asymptomatic and most importantly doesnt feel them. (When he has had a bad sore throat or flu and I take him to get checked he really looks overly concerned that something is wrong with him). I agree with her on that I dont want to get him worried and maybe risk have him worrying about them excessively. I suffered from them for over 20 years and just in last 4 years I started to stop worrying about them.Its such a fine balance right now I just dont know what to do.  I just want to say that I have felt these extra beats at times in my son as I do take my childrens pulse rates once in a blue moon (very sporadically) just to make sure that everything is fine.  Like I stated above I have been suffering from PVC's for over 20 years and do worry about them. I agree with my doctor and because he is totally asymptomatic and doesn't feel them I dont really want to put him through the worry testing would bring on.  Should I insist though?

[CCF-M.D.-MJM]

Hi Annako,

I am glad to hear that you have come to peace with your PVCs.  This can a very difficult process and many people never reach a state of peace.  That being said, if you son has no symptoms what so ever, I would not order any extra tests if he has a normal physical exam.  

It is important to know that normal lab values are based on the population normals and 5% of normal people way fall outside these values.  If you do a random 20 tests, one of them is going to lead to values that are concerning.  That is why it is important to only order tests if you have a strong clinic suspicion that something is wrong.  

Everybody has PVCs or PACs.  I only tests people that are significantly symptomatic or concerned.  I would not test an asymptomatic 18 year old.  You might not like my last  piece of advice, but I think for your sanity, it is important to mention.  If you son is feeling ok and not having any symptoms, don't check his pulse.  The only reason you are worried is because you are essentially ordering a test on an a symptomatic person with a low clinic suspion of a problem.

I hope this helps answer  your question.  Good luck and thanks for posting.

[kitcurious]

My son's echo result was 1600+ PAC's PVCs. In the absence of structural abnormalities he will not require treatment for those, though he may have other issues with function. My son had the echo cardiogram because he had an obvious murmur and numerous ectopic beats when the doctor listened to his chest during a regular check up. He also had been born with a hole in the heart.  The doctor explained them to both of us, and we haven't talked about it since because he feels fine. My son will have a follow-up later when the cardiologist views the echo for herself. At this point there is no need to medicate him, and his beats are easily detected and quite numerous the GP doctor could hear them on examination. The quick ekg the GP then gave him showed the ectopic beats as well. If your son doesn't feel anything and the doctor doesn't hear anything perhaps an ekg or echo could be still be done, but you would need to honestly determine if this would be to satisfy your anxiety more than for medical reasons.  It would be well-advised to not shift anxiety to him.

[kitcurious]

pardon me his HOLTER result was 1600